Osteoarthrosis of the temporomandibular joint. A clinical and radiological study of 16 patients.
(41/493)
A study is made of the clinical and radiological characteristics of 16 patients with osteoarthrosis (OA) of the temporomandibular joint (TMJ). The study comprised those patients satisfying the diagnostic criteria for OA proposed by Stegenga et al. in 1989. The patients were subjected to a clinical and radiological diagnostic protocol (including the obtainment of magnetic resonance imaging data). The most relevant clinical findings were the detection of crepitants in 93.8% of cases, with a reduction in mandibular movement range. Radiology in turn identified joint surface alterations in 62% of cases on the right side, and in 68.8% of the patients on the left side. The joint disc dynamic position study showed anterior displacement without reduction in 50% of cases in the right joint and in 43.8% of patients in the left joint. In conclusion, patients with OA of the TMJ present joint sounds and a reduced mandibular movement range - the salient radiological characteristic being altered joint morphology. (+info)
Retrieval of a retrograde catheter using suction, in patients who cannot open their mouths.
(42/493)
In difficulty, tracheal intubation can be facilitated by passing a retrograde catheter, but the mouth has to be opened for the retrieval of the catheter from the pharynx. Two patients with ankylosis of a temporomandibular joint were unable to open their mouth, and required general anaesthesia for gap arthroplasty. Because we did not have a flexible fibreoptic laryngoscope, we used a suction catheter to retrieve an epidural catheter from the pharyngeal cavity, which had been passed retrogradely from a cricothyroid puncture. Catheter-guided tracheal intubation was done without complication. A suction catheter can assist retrograde retrieval of a catheter to aid intubation in patients who cannot open the mouth. (+info)
Massive calcium pyrophosphate dihydrate crystal deposition disease: a cause of pain of the temporomandibular joint.
(43/493)
Calcium pyrophosphate dihydrate deposition (CPDD) disease is a disorder that occasionally affects the temporomandibular joint (TMJ) and temporal bone, causing pain (66.6% of cases), swelling (50%), trismus (36.8%), and hearing loss (22.2%). Diagnosis of CPDD is challenging because clinical symptoms and imaging features are not characteristic and may mimic a chondrosarcoma. When the diagnosis of CPDD of the TMJ is under consideration, conventional radiographs of the wrist or the knee may contribute to the final diagnosis. Imaging features of CPDD are discussed with a review of the literature. (+info)
Temporomandibular disorders in Turkish children with mixed and primary dentition: prevalence of signs and symptoms.
(44/493)
The prevalence of signs and symptoms related to TM (temporomandibular) disorders was examined in 40 children with primary dentition and in 40 children with mixed dentition. The purpose of this study was to evaluate the relationship between dentition and TM disorders in the examined population. Maximum mouth opening was also evaluated. Clinical examination was done by one investigator. A questionnaire was used in combination with the clinical examination. The results showed that there was an increase in signs and symptoms from the primary to the mixed dentition group, but only the joint sounds were found significantly different between the two groups. There was no statistically significant difference in maximum mouth opening capacity between the groups. (+info)
Dental and facial characteristics of patients with juvenile idiopathic arthritis.
(45/493)
OBJECTIVE: It has been shown that the temporomandibular joint is frequently affected by juvenile idiopathic arthritis, and this degenerative disease, which may occur during facial growth, results in severe mandibular dysfunction. However, there are no studies that correlate oral health (tooth decay and gingival diseases) and temporomandibular joint dysfunction in patients with juvenile idiopathic arthritis. The aim of this study is to evaluate the oral and facial characteristics of the patients with juvenile idiopathic arthritis treated in a large teaching hospital. METHOD: Thirty-six patients with juvenile idiopathic arthritis (26 female and 10 male) underwent a systematic clinical evaluation of their dental, oral, and facial structures (DMFT index, plaque and gingival bleeding index, dental relationship, facial profile, and Helkimo's index). The control group was composed of 13 healthy children. RESULTS: The mean age of the patients with juvenile idiopathic arthritis was 10.8 years; convex facial profile was present in 12 juvenile idiopathic arthritis patients, and class II molar relation was present in 12 (P =.032). The indexes of plaque and gingival bleeding were significant in juvenile idiopathic arthritis patients with a higher number of superior limbs joints involved (P =.055). Anterior open bite (5) and temporomandibular joint noise (8) were present in the juvenile idiopathic arthritis group. Of the group in this sample, 94% (P =.017) had temporomandibular joint dysfunction, 80% had decreased mandibular opening (P = 0.0002), and mandibular mobility was severely impaired in 33% (P =.015). CONCLUSION: This study confirms that patients with juvenile idiopathic arthritis a) have a high incidence of mandibular dysfunction that can be attributed to the direct effect of the disease in the temporomandibular joint and b) have a higher incidence of gingival disease that can be considered a secondary effect of juvenile idiopathic arthritis on oral health. (+info)
Can temporomandibular dysfunction signs be predicted by early morphological or functional variables?
(46/493)
The aim of the present study was to establish whether the early signs of various orofacial dysfunctions, malocclusions, or occlusal interferences can predict the development of temporomandibular dysfunction (TMD) in young adults. Forty-eight subjects referred for speech therapy and 49 controls participated in all four stages of this longitudinal study. The subjects were examined at the ages of 7, 10, 15, and 19 years. The phoniatrician diagnosed errors in place of articulation and problems in the movement and co-ordination of the speech articulators. Occlusion, TMD signs (palpatory tenderness of the masticatory muscles, and of temporomandibular joints (TMJ), jaw deviation on opening, and clicking), mandibular movement capacity and occlusal interferences were registered by the orthodontist. Multiple logistic regression models were applied in order to evaluate whether single signs of TMD at the age of 19 years were related to previous/present malocclusions or interferences, to misarticulations of speech, problems in oral motor skills, or other signs of TMD. The effect of gender was also considered. The results showed that excessive overjet was the only variable which seemed to consistently increase the risk of TMD. In addition, girls seemed to be more prone to the development of TMD than boys. Although, during growth, there were both local and central factors associated occasionally with TMD development, the predictive value of those variables in the estimation of the individual risk of TMD was rather small. (+info)
Fluoroscope-aided retrograde placement of guide wire for tracheal intubation in patients with limited mouth opening.
(47/493)
Passing a retrograde catheter/wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fibre-optic bronchoscope or an expert user of such a device is not available. Some mouth opening is essential for the oral and/or nasal retrieval of the catheter/wire from the pharynx. Two patients with temporo-mandibular joint (TMJ) ankylosis and extremely limited mouth opening required gap arthroplasty of the TMJ under general anaesthesia. Because we did not have a flexible fibre-optic bronchoscope, we performed fluoroscopy-assisted nasal retrieval of the guide wire passed up through a cricothyroid puncture and subsequently accomplished wire-guided naso-tracheal intubation. In the absence of a flexible fibre-optic bronchoscope, this technique is a very useful aid to intubation in patients with limited mouth opening. (+info)
Treatment of hemifacial microsomia in a growing child: the importance of co-operation between the orthodontist and the maxillofacial surgeon.
(48/493)
The treatment of patients with hemifacial microsomia (HM) always requires an interdisciplinary approach including at least maxillofacial surgery and orthodontics. Co-operation not only within the team, but also with the patients and their family is essential in order to achieve the best results. In the case history of the 10-(1/2) year old female patient reported here, three surgical interventions (two with costo-chondral bone grafts) and a 3-year orthodontic treatment have taken place. A harmonious facial and occlusal result was finally reached. (+info)